Registration for the 2016-2017 AWANA club year is now open!Please complete the fields below to register.

Parent/Guardian Information

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

What is your relationship to clubbers? *

Home Phone Number *

Mobile Phone Number *

Email *

Church you attend *

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Clubbers Information

Name *

First

Last

Gender *

MaleFemale

Birthdate *

Grade Entering *

Allergies/Special Needs *

Name *

First

Last

Gender *

MaleFemale

Birthdate *

Grade Entering *

Allergies/Special Needs *

Name *

First

Last

Gender *

MaleFemale

Birthdate *

Grade Entering *

Allergies/Special Needs *

Name *

First

Last

Gender *

MaleFemale

Birthdate *

Grade Entering *

Allergies/Special Needs *

Pick Up

Please list anyone that can pick up your child(ren) other than the parent/guardian listed above.

Name *

First

Last

Name *

First

Last

Relationship to child *

Relationship to child *

Cell Phone Number *

Cell Phone Number *

Release of Liability

1) I understand that my child/children may participate in physical activities such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability, Five Forks Baptist Church and any persons involved in the AWANA Club.

2) In the event of an emergency that requires medical treatment for the above named child/children, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the AWANA volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accident or treatment of my child.

3) I grant permission for my child/children to be included in an unpublished club directory to be used by AWANA leaders only. I also give permission for my child/children to be included in any photo/video included in AWANA print and online materials as long as my child/children are not identified by first and last name.

4) I grant permission for my child/children to travel to/from AWANA Club events with an adult leader. Any such event will be clearly communicated with me beforehand.

Please type your name stating that you have read and agree to the above release *

Important Note

The number of clubbers we can accommodate will depend on the number of volunteers we have for each club. It is fun to do AWANA together! We have a need for volunteers in many areas - no experience needed! Whatever your interests, we have a spot for you. From volunteering weekly with a group of kids, to assisting check-in at the beginning of each club night, to serving just a few nights a year in our store - we would love to have you join us!